Elder Guru

The Medicare Coverage Gap (Donut Hole) Explained

Medicare is clear that you may have a coverage gap in Part D of your plan. A coverage gap means you may end up paying out-of-pocket for your medication. The donut hole (coverage gap) is one of four phases in your Medicate Part D coverage that may result in additional out-of-pocket expenses.  With list prices for prescription medication on the rise, as much as 159 percent in 2018, it is essential that you not only understand Medicare’s coverage gap but also that you take the time to find ways to…

Will Medicaid or Medicare Cover Tattoo Removal?

Medicare covered tattoo removal? Medicaid covered tattoo removal? Are these covered services? Dermatologists offer laser removal, but will your insurance cover it? Have a tattoo you want removed? Perhaps you have the name of a now ex-husband or wife tattooed on your arm. Maybe you had a few post-apocalyptic tattoos that now don’t look so good. Maybe you’re just tired of them. Either way, you’ve decided you want them gone. Then you found out that the average cost for laser tattoo removal is $250-$500 per treatment. The price depends on…

Understanding Medicare Webinar – Open Enrollment October 15th

Medicare Open Enrollment begins October 15, so now is the time to refresh your understanding of key components of the Medicare program. The National Information & Referral Center is hosting a webinar on Understanding Medicare. This webinar will teach you about Medicare eligibility and coverage options as well as educational resources from Medicare Made ClearTM that can assist I&R/A agencies and consumers. Date and time: Wednesday, October 5, 2016 3:00 pm Eastern Daylight Time (New York, GMT-04:00) Duration: One hour Register for this even by clicking here.

Medicare and Social Security: Resources To Know

Medicare offers a new interactive map showing geographic disparities in chronic disease among Medicare recipients. This map examines racial and ethnic disparities, as well as geographic, across the United States. Take a closer look for data on many specific topics, including: The prevalence of 18 chronic conditions Medicare spending Hospital utilization, preventable hospitalizations and readmissions Mortality rates Offered by the Centers for Medicare and Medicaid Services Office of Minority Health, the map is designed to help target populations for interventions. Users can sort by state or county of residence, age,…

Mark Your Calendar: Upcoming Events for Professionals

ASA’s Annual Aging in America Conference What: The American Society on Aging (ASA) hosts an annual conference to share knowledge on topics aging professionals face today. Learn about aging and community, the economics of aging, the next 50 years of Medicare and Medicaid, culturally competent services, and much more. Who: Professionals working within the aging community, including ASA members, nonmembers, seniors, and students. When: March 20-24 Where: Marriott Wardman Park and Omni Shoreham Hotels, Washington, D.C.  Register here. Health Management Associates Webinar What: This webinar will focus on targeting readmissions.…

10 Things You Should Know About Caregiving

Caregiving’s a tough job, but you’re not in it alone. Put these tips and resources in your toolbox. For All Caregivers Prepare Early Even if your family’s healthy, having a plan can ease stress if illness or disability does strike. Talk to parents or any loved one about their potential needs, hold a family meeting, and agree on an action plan. Medicare charts what every caregiver should know, and the Family Caregiver Alliance provides a Caregiving 101 primer. Topics you’ll want to consider include legal planning, financial planning, and first…

CMS Pilot Project to Test Improving Health by Connection to Social Services

The Department of Health and Human Services revealed a pilot program with $157 million in funding to test the bridge between clinical care and social services. The program will determine whether screening beneficiaries for health related social needs and referral to community based services will improve quality and affordability in Medicare and Medicaid. “For decades, we’ve known that social needs profoundly affect health, and this model will help us understand which strategies work to help improve health and spend dollars more wisely,” explained Dr. Patrick Conway, CMS Deputy Administrator and…

New Reports from the National Study of Long-Term Care Providers Summarized

Long-term care for the elderly is a crucial issue. Each year, new data sheds light on the state of care in the United States. The National Study of Long-Term Care Providers reports on trends in residential care communities and adult day care centers. The study examines resident demographics, medical conditions, funding sources, and other variables. Read 2014’s highlights below, and check out the full reports for more detailed information. Variation in Operating Characteristics of Residential Care Communities, by Size of Community More than 6 in 10 residential care communities had…

The Cost of Dementia Care is Rising

What is the cost of dementia care? The cost of dementia care outpaces heart disease and cancer, two other leading killers, in cost over time. Researchers recently found that dementia patients on Medicare faced far more out-of-pocket expenses. The average cost to a dementia patient after Medicare pays its share was $61,522, over 80% more than heart disease or cancer patients paid. Largely, this discrepancy is due to the cost of in-home caregivers, who attend to a dementia patient around the clock. This expense is usually not covered by Medicare.…

Diabetes and Patient Assistance Programs

Diabetes is a serious condition in which the body does not process food properly for energy.  It is a condition in which a person’s body either doesn’t make enough insulin or is unable to use his/her own insulin in the way it should when dealing with diabetes (source). There is a high prevalence in seniors with diabetes (diagnosed and undiagnosed) at 25.9%, or 11.8 million according to diabetes.org.  Paying for the cost of medication and testing supplies can be very expensive, especially when an older adult hits the donut hole and the…

Donut Hole Days: Medicare Part D Coverage Gap

As we approach the end of the year, many seniors are falling into the infamous “donut hole” or Medicare Part D prescription drug coverage gap and panicking at the costs. Fortunately, the coverage gap has been steadily decreasing, thanks to changes from the Affordable Care Act, and fewer people are entering the gap stage.  Moving forward, the gap will continue to shrink and fewer people will fall into it each year (source).However, those who do and are on a fixed income may experience serious financial strain as they are forced…

Medicare Part B Premiums: Will Yours Be Raised in 2016?

Medicare Part B could raise some premiums in the new year by as much as 52 percent. The hike would be the largest in Medicare’s history. Recipients affected would pay increased monthly premiums, from about $104.90 to $159.30, or $318.60 for married couples. Recipients with higher incomes would pay more. According to estimates, those in the highest income bracket will see premiums rise to approximately $509.80 per month. For about 70 percent of Medicare beneficiaries, however, the premiums will remain the same. These recipients have Medicare premiums deducted directly from…